Cushing's disease
Cushing's disease, also called hyperadrenocorticism, is a malfunction of the adrenal gland making it overproduce the hormone cortisol. One of the normal functions of cortisol is to raise blood sugar, and so the high cortisol levels keep blood glucose levels at continual high levels, causing a form of secondary diabetes. Like anything that causes prolonged hyperglycemia, one of the side effects over time can be permanent diabetes. Some causes of Cushing's are pituitary or adrenal gland tumors and overuse of glucocortoid steroids. The basic connection between Cushing's and diabetes is this: the excess cortisol produced by the faulty adrenal gland is a signal for the body to produce new, non-sugar sourced glucose (Gluconeogenesis). When this additional glucose reaches the bloodstream, another signal goes off; this one to the endocrine pancreas to produce more insulin to handle the glucose present in the blood. When the insulin production ability of the pancreas can no longer keep up with the additional blood glucose which the excess cortisol from the malfunctioning adrenal gland keeps emitting, the islet cells of the endocrine pancreas are exhausted, and diabetes results. In effect, the overproductive adrenal gland has the capability to "burn out" the insulin producing capability of the pancreas. If the islet cells of the pancreas are still able to produce sufficient endogenous insulin for the body's needs, controlling the Cushing's will also control the blood glucose, meaning there would be no need for insulin injections. If the pancreas' islet cells have sustained such damage as to be unable to produce enough insulin for the body, insulin shots are necessary. Cases of Cushing's disease are relatively common in dogs but less so in cats. These are common symptoms in dogs and these are common symptoms in cats. Cats with Cushing's often have very fragile skin; pets with Cushing's often do not heal as quickly regarding surgeries or injuries. Depending on what's causing the Cushing's, treatment can range from surgery (in some tumor cases) to courses of treatment with Lysodren, Ketaconazole, Anipryl or Trilostane , all of which are described here. There is sometimes the medical need to either remove or destroy the adrenal glands through medication. This causes Addison's disease--a lack of enough cortisol, and means replacement cortisone medication must be taken for life. Trilostane, known as Vetoryl when dispensed for veterinary purposes, and Modrenal, when prescribed for people, is the only approved treatment for Cushing's in the UK. It has yet to be approved for animals in the US; there are two ways to obtain it, however. FDA red tape is needed to import it under the veterinary brand name Vetoryl. The drug, however, is approved in the US for use in some human conditions--it is simply not available in the US. One can order it under the human Rx name of Modrenal and receive it minus the FDA red tape from Masters Marketing in the UK. Arnolds, also in the UK, is the exclusive distributor of the drug under the veterinary Vetoryl name. They are also a source of information for how to use the drug for veterinary purposes. For dogs with both Cushing's and diabetes, the key to starting or maintaining regulation is effective control of the Cushing's. Ending the excess of cortisol production allows the diabetes to be managed. In cases where Cushing's is the primary condition, causing transient, or secondary diabetes, it may be possible to return to non-diabetic status with successful management of Cushing's. Another health problem for canine Cushing's patients is high blood pressure (hypertension). A 1996 JAVMA study found 86% of study dogs with Cushing's to be suffering from hypertension. It also found that 40% of them continued having high blood pressure after effective management of the Cushing's. About 80% of cats and 10% of dogs with Cushing's are diabetic. In dogs, breeds such as Boston Terriers, German Shepherds, Poodles, Boxers, Dachshunds and Scotties, seem to be genetically predisposed to Cushing's Disease. This is to say that it is most commonly diagnosed in dogs of the breeds above; any dog can be diagnosed with Cushing's regardless of his/her breed. Another disorder of the adrenal gland causes it to produce less than normal cortisol. It is known as Addison's disease and is the direct opposite of Cushing's disease. External Links *Pet Owner's Crash Course in Canine Cushing's Disease *Canine Cushing's Message Board where help and support are available. *Cushing's Syndrome Information Website * Cushing's disease in cats * Tests for Cushing's in cats and dogs *The Story of Jack, a 14 year old UK canine with Cushing's using Vetoryl (trilostane). Other treatment methods are discussed and some helpful links. *Canine Hyperadrenocorticism, Diabetes Mellitus, or Both? A Clinical Guide to Differentiating Between These Disease: They Share Some Common Symptoms *Diagnosing Hyperadrenocorticism--Dr. David Bruyette Category:ConditionsCategory:ComplicationsCategory:Other conditions and procedures